Payer AR Specialist I

Atrium Health Floyd - Rome, GA

Full-time

Rome, GA

About the position

The Payer Accounts Receivable Specialist I plays a crucial role in the financial services department by monitoring the payment status of claims submitted to assigned payers. This position requires diligent follow-up with payer representatives to ensure that timely payments are received. The specialist will track and complete follow-up tasks as identified, ensuring that all accounts receivable are managed effectively. In addition to monitoring accounts receivable, the specialist will also investigate and work on denials or refund requests received from assigned payers. This role demands an individual who can manage and prioritize multiple tasks to meet deadlines and departmental goals. The Payer Accounts Receivable Specialist I will report to the Supervisor of Post-Claim and will receive daily oversight from the Team Lead of Accounts Receivable and Denials. The ideal candidate for this position should possess a high school diploma or equivalent and have at least one year of experience in a physician billing office setting. A working knowledge of accounts receivable is essential, along with familiarity with Medicare, Medicaid, commercial insurance, workers' compensation, and other insurance industry operating procedures. Proficiency in computer skills is necessary, and a basic understanding of medical terminology, as well as prior experience with ICD-9 or ICD-10, CPT, and HCPCS coding, is preferred. The specialist should be proficient in filing and collecting insurance claims from individual carriers or agencies. In addition to the required qualifications, the candidate should demonstrate effective verbal and written communication skills, a commitment to high-quality customer service, and the ability to work independently without direct supervision. The role requires the ability to prioritize and manage multiple tasks simultaneously and to effectively anticipate and respond to issues in a dynamic work environment. The specialist should also be dedicated to treating both internal and external constituents as clients and customers, maintaining a flexible customer service approach that emphasizes satisfaction and quality.

Responsibilities

• Monitor status of accounts receivable for assigned payers and follow up within specified timeframes
• Investigate denials from assigned payers and submit appeals when appropriate
• Validate recoupments or refund requests from payers
• Process recoupment or refund requests from payers when appropriate
• Ensure tasks are managed and properly documented within practice management system work queues; maintain productivity standards set by post-claim leadership team
• Strive for a positive customer service experience
• Maintain reception desk/work areas
• Comply with all federal, state, or other regulatory requirements
• Adhere to Floyd Healthcare Management Inc. organizational policies and procedures for relevant location and job scope
• Perform other miscellaneous duties as assigned

Requirements

• High school graduate or equivalent
• One year or more experience in a physician billing office setting
• Working knowledge of accounts receivable
• Knowledge of Medicare, Medicaid, commercial insurance, workers' compensation, and other insurance industry operating procedures
• Proficient computer skills
• Basic knowledge of medical terminology and prior experience with ICD-9 or ICD-10, CPT, and HCPCS coding is preferred
• Proficiency in filing and collecting insurance claims from individual carriers or agencies

Nice-to-haves

• Effective verbal and written communication skills
• Demonstrates a sincere commitment to high quality customer service
• Self-motivated and able to work efficiently without direct supervision or continuous instruction
• Ability to prioritize and manage multiple tasks simultaneously
• Ability to work well with others
• Demonstrated ability to use PC based office productivity tools (e.g. Microsoft Outlook, Microsoft Excel, Word)
• General computer skills necessary to work effectively in an office environment
• Dedication to treating both internal and external constituents as clients and customers
• Maintaining a flexible customer service approach and orientation that emphasizes service satisfaction and quality